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NPI Code Detail

MEDICARE: DR. CHRISTOPHER RIDDELL MD

MEDICARE: DR. CHRISTOPHER RIDDELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician021796GA

General Provider Information

NPI Number : 1144202318
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER RIDDELL MD
Provider Business Mailing Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 770-644-1570
Fax Number : 770-644-1576
Provider Business Practice Location Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 770-644-1570
Fax Number : 770-644-1576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 07/23/2014

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Directions to “ DR. CHRISTOPHER RIDDELL MD” Practice Location

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